WAC 182-12-205
May a retiree defer enrollment in a PEBB
health plan at or after retirement? Except as stated in
subsection (1)(c) of this section, if retirees defer
enrollment in a PEBB health plan, they also defer enrollment
for all eligible dependents. Retirees may not defer their
retiree term life insurance, even if they have other life
insurance, except as allowed in WAC 182-12-209(3).
(1) Retirees may defer enrollment in a PEBB health plan
at or after retirement if continuously enrolled in other
comprehensive employer sponsored medical as identified below:
(a) Beginning January 1, 2001, retirees may defer
enrollment if they are enrolled in comprehensive
employer-sponsored medical as an employee or the dependent of
an employee.
(b) Beginning January 1, 2001, retirees may defer
enrollment if they are enrolled in medical as a retiree or the
dependent of a retiree enrolled in a federal retiree plan.
(c) Beginning January 1, 2006, retirees may defer
enrollment if they are enrolled in medicare Parts A and B and
a medicaid program that provides creditable coverage as
defined in this chapter. The retiree's dependents may
continue their PEBB health plan enrollment if they meet PEBB
eligibility criteria and are not eligible for creditable
coverage under a medicaid program.
(2) To defer health plan enrollment, the retiree must
submit the appropriate forms to the PEBB program requesting to
defer. The PEBB program must receive the form before health
plan enrollment is deferred or no later than sixty days after
the date the retiree becomes eligible to apply for PEBB
retiree insurance coverage.
(3) Retirees who defer may enroll in a PEBB health plan
as follows:
(a) Retirees who defer while enrolled in comprehensive
employer-sponsored medical may enroll in a PEBB health plan by
submitting the appropriate forms and evidence of continuous
enrollment in comprehensive employer-sponsored medical to the
PEBB program:
(i) During annual open enrollment. (PEBB health plan
will begin January 1st after the annual open enrollment.); or
(ii) No later than sixty days after their comprehensive
employer-sponsored medical ends. (PEBB health plan will begin
the first day of the month after the comprehensive
employer-sponsored medical ends.)
(b) Retirees who defer enrollment while enrolled as a
retiree or dependent of a retiree in a federal retiree medical
plan will have a one-time opportunity to enroll in a PEBB
health plan by submitting the appropriate forms and evidence
of continuous enrollment in a federal retiree medical plan to
the PEBB program:
(i) During annual open enrollment. (PEBB health plan
will begin January 1st after the annual open enrollment.); or
(ii) No later than sixty days after the federal retiree
medical ends. (Enrollment in the PEBB health plan will begin
the first day of the month after the federal retiree medical
ends.)
(c) Retirees who defer enrollment while enrolled in
medicare Parts A and B and medicaid may enroll in a PEBB
health plan by submitting the appropriate forms and evidence
of continuous enrollment in creditable coverage to the PEBB
program:
(i) During annual open enrollment. (Enrollment in the
PEBB health plan will begin January 1st after the annual open
enrollment.); or
(ii) No later than sixty days after their medicaid
coverage ends (Enrollment in the PEBB health plan will begin
the first day of the month after the medicaid coverage ends.);
or
(iii) No later than the end of the calendar year when
their medicaid coverage ends if the retiree was also
determined eligible under 42 U.S.C. § 1395w-114 and
subsequently enrolled in a medicare Part D plan. (Enrollment
in the PEBB health plan will begin January 1st following the
end of the calendar year when the medicaid coverage ends.)
(d) Retirees who defer enrollment may enroll in a PEBB
health plan if the retiree receives formal notice that the
department of social and health services has determined it is
more cost-effective to enroll the retiree or the retiree's
eligible dependent(s) in PEBB medical than a medical
assistance program.
[Statutory Authority: RCW 41.05.160 and 2011 c 8. 11-22-036
(Order 11-02), § 182-12-205, filed 10/26/11, effective 1/1/12.
Statutory Authority: RCW 41.05.160. 10-20-147 (Order
10-02), § 182-12-205, filed 10/6/10, effective 1/1/11;
09-23-102 (Order 09-02), § 182-12-205, filed 11/17/09,
effective 1/1/10; 08-20-128 (Order 08-03), § 182-12-205, filed
10/1/08, effective 1/1/09; 08-09-027 (Order 08-01), §
182-12-205, filed 4/8/08, effective 4/9/08; 07-20-129 (Order
07-01), § 182-12-205, filed 10/3/07, effective 11/3/07. Statutory Authority: RCW 41.05.160 and 41.05.068. 06-23-165
(Order 06-09), § 182-12-205, filed 11/22/06, effective
12/23/06. Statutory Authority: RCW 41.05.160, 41.05.350, and 41.05.165. 05-16-046 (Order 05-01), § 182-12-205, filed
7/27/05, effective 8/27/05. Statutory Authority: RCW 41.05.160 and 41.05.165. 04-18-039, § 182-12-205, filed
8/26/04, effective 1/1/05.]